Lifestyle Modifications for Patients to Adapt During COVID-19



Deepak Bhatt, MD, MPH: You mentioned that physical activity can be monitored. I’ve seen conflicting reports, and I’ve seen in some reports that the coronavirus pandemic has led to the proliferation of couch potatoes, whereas in other reports, some folks don’t have to commute to the office, so they’ve got an extra hour or 2 every day, and they’re using some portion of that to exercise. What is your feeling, either from your own patients or from some trials or data that you’re gathering? What’s happening out there with physical activity and diet?

C. Michael Gibson, MS, MD: There are 2 things: the COVID-19 weight gain, the weight gain of 19 pounds is real after talking to a lot of people. I’ve gained a few pounds. I don’t think people are getting out and around as much as they used to. Both of those—weight gain and physical exertion—have gone in the wrong direction.

An exception is in my household where my family is fighting over getting on the Peloton, and they keep fighting to get me to get on it. I keep claiming that I don’t have shoes, and they said they’re getting me shoes. I told them I would do the cooldown phase of it, but it’s sad.

You can get out and about and do things like walk your dog, so I walk Piper, my dog, and that has not changed, although I stay inside the yard. You can get out and about. At this point, walking is something people should be doing. It’s probably safe. If you go near someone, wear a mask. Get out and get active. That’s 1 of the things that is going to be most dangerous about this pandemic, Deepak: people sitting at home. Why do they call it Zoom when we don’t move for 12 hours a day? I should be on a NOAC [novel oral anticoagulant] or something.

Deepak Bhatt, MD, MPH: Maybe we all should. No, you’re quite right. In some cases, people might be exercising more and eating better. There’s certainly, for some people, the reduction of work-related stress, which can occasionally incite an acute coronary syndrome. In aggregate, there’s been an increase in body mass index and waist circumference with worse diets and greater caloric intake. In aggregate, our collective cardiovascular risks have gone up and not gone down because of COVID-19 [coronavirus disease 2019]. That might help fuel this whole cardiovascular epidemic that was there before the pandemic. The collision of the 2 could raise cardiovascular events in months and years to come. We’ll see. Hopefully not, but that might happen.

Before we close, any parting words of wisdom for our audience?

C. Michael Gibson, MS, MD: In terms of prevention, Deepak, I keep tweeting out, “Masks save lives. Wear your mask.” That’s probably the single most effective thing you can do to prevent infection in others and prevent infection somewhat in yourself. If we did that, all of us, we would stand a good chance of getting this R0, the rate of spread, down below 1. We have just got to be more disciplined.

As a country, we have got to learn to work together. We have a lot of creative people out there with a lot of great ideas, but we are the enemy. We have got to stop the infighting. We’ve got to come together and do some larger projects as a country to sort out some of these ongoing questions and find the answers.

Deepak Bhatt, MD, MPH: I agree with you. There is no way to win against this sort of enemy, a virus, if there is fracture. There has to be unity. This is not the sort of thing where some of us can do well if others aren’t. Obviously, this is an infection that can spread unless it’s controlled in all regions of the United States and, as you alluded to early on, the world. We will all pay the price and continue to pay the price.

Thanks, Mike. This has been an incredible conversation with you. I’ve learned a lot, as I always do, speaking with you. Thanks for all the insights. I also want to thank the audience. Hopefully you’ve enjoyed watching this HCPLive® presentation. We hope you’ve found this Peers and Perspectives® discussion to be useful and informative. Thank you so much for joining.

C. Michael Gibson, MS, MD: Thanks for having me, Deepak.

Transcript Edited for Clarity

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